Autonomous VR Exposure Therapy for Anxiety Disorders Using Conversational AI—Ethical and Technical Implications and Preliminary Results

The need for psychotherapy is very high and the lack of care causes a lot of suffering and high costs. This paper presents an interdisciplinary approach to creating an AI-guided exposure therapy for fear of heights in virtual reality (VR). First, ethical principles for the use of conversational AI in psychotherapy were translated into technical requirements and made measurable. Based on this, an autonomous virtual reality exposure therapy was iteratively developed with a therapist. The feasibility and implementation of the ethical principles were tested with a patient. The patient was very satisfied with the VR setup. The AI therapist was also rated positively, although there is still room for improvement regarding conversational skills. Overall, the paper shows how AI can contribute responsibly to improving the psycho-therapeutic supply. It also provides guidelines that make ethical principles tangible and measurable for developers.

Virtual reality-based rehabilitation in patients following total knee arthroplasty:a systematic review and meta-analysis of randomized controlled trials

Background:Physical therapy is regarded as an essential aspect in achieving optimal outcomes following total knee arthroplasty(TKA).The coronavirus disease 2019(COVID-19)pandemic has made face-to-face rehabilitation inaccessible.Virtual reality(VR)is increasingly regarded as a potentially effective option for offering health care interventions.This systematic review and meta-analysis investigate VR-based rehabilitation's effectiveness on outcomes following TKA.Methods:From inception to May 22,2021,PubMed/Medline,Embase,Web of Science,the Cochrane Central Register of Controlled Trials,Scopus,PsycINFO,Physiotherapy Evidence Database,China National Knowledge Infrastructure,and Wanfang were comprehensively searched to identify randomized controlled trials(RCTs)evaluating the effect of VR-based rehabilitation on patients following TKA according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the Cochrane Handbook for Systematic Reviews of Interventions.Results:Eight studies were included in the systematic review,and seven studies were included in the meta-analysis.VR-based rehabilitation significantly improved visual analog scale(VAS)scores within 1 month(standardized mean difference[SMD]:−0.44;95%confidence interval[CI]:−0.79 to−0.08,P=0.02),the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)within 1 month(SMD:−0.71;95%CI:−1.03 to−0.40,P<0.01),and the Hospital for Special Surgery Knee Score(HSS)within 1 month and between 2 months and 3 months(MD:7.62;95%CI:5.77 to 9.47,P<0.01;MD:10.15;95%CI:8.03 to 12.27,P<0.01;respectively)following TKA compared to conventional rehabilitation.No significant difference was found in terms of the Timed Up and Go(TUG)test.Conclusions:VR-based rehabilitation improved pain and function but not postural control following TKA compared to conventional rehabilitation.More high-quality RCTs are needed to prove the advantage of VR-based rehabilitation.As the COVID-19 pandemic continues,it is necessary to promote this rehabilitation model.